Mend Physical Therapy Blog and Injury Information

Treating Lateral Elbow Pain in Rock Climbers

July 7, 2021

Pain to the elbow is very common among climbers and is one of the leading causes of time away from the sport. The most likely areas of pain are to the lateral elbow or medial elbow. Keep reading to learn more about the symptoms, causes, and treatment options for elbow pain.


Lateral epicondylalgia (also known as lateral elbow pain, located on the outer portion of the elbow) can be caused by several underlying conditions, but is most commonly a localized tendinopathy of the extensor carpi radialis brevis. This muscle/tendon attaches to the lateral epicondyle of the humerus bone and is responsible for stabilizing the wrist and elbow while climbing. The structure can get irritated by over-use, muscle weakness, poor climbing mechanics, or forearm muscle imbalances. Over time, this can develop into tendinopathy which consists of degenerative changes to the muscle/tendon unit.


One common cause of lateral epicondylalgia is muscle weakness and climbers tend to have significant weakness to their wrist and finger extensor muscles. This is due to over-development of the finger and wrist flexors which are the primary muscles of gripping while climbing. One study found that climbers actually have WEAKER than average finger extensor strength compared to people who are non-climbers!


Common symptoms: aching or sharp pain to the outer portion of the elbow. Tenderness to the touch of the forearm muscles or the bone on the outside of the elbow. Symptoms are aggravated by rock climbing (especially small crimpers), lifting or holding heavy objects, fine motor tasks, and can be constant throughout the day.


How it is treated: the current best evidence shows that lateral epicondylalgia is treated with a combination of manual therapy and exercise therapy. Manual therapy may focus on elbow joint mobilization, soft tissue massage, or dry needling. Exercise therapy will likely consist of a progressive loading program of the painful muscle/tendon. This exercise program is the key to promoting tissue regeneration and long term healing of the muscle/tendon. Depending on the severity, the exercise program will start with low-load exercises and progress to increasingly challenging loads to further promote tissue reorganization and strength.


If you are having elbow pain, schedule an appointment with the experts at Mend to get a proper diagnosis and evidence-based treatment plan.